More than 100 employees at Liberty Hospital will be out of a job by the end of next week. The hospital says the layoffs are a response to a perfect storm in health care right now. That includes reduced Medicare and Medicaid payments, changes in the way hospitals will be reimbursed for care under the federal health law and increasing demands for charity care as individual health insurance costs go up.

Liberty is a 250-bed public hospital serving Clay and Platte counties and other parts of northwest Missouri. It has nearly 2,000 employees. Severance packages for those losing their jobs will depend on how long they’ve been employed.

Liberty Hospital is a 250-bed public hospital just north of Kansas City.

Credit Liberty Hospital

“We’ve had cuts through all layers of the hospital, from senior layers all the way down through nutritional services,” says Julie Simpson, a spokesperson for the hospital.

Over the last few months, hospital leaders have been looking to reduce expenses by $20 million while at the same time improving its quality of care and use of resources.

The move is in part because hospitals like Liberty may be facing new Medicare payment penalties based on their readmissions rates for certain medical conditions. Hospitals are also bracing for reduced federal funding aimed at subsidizing care for patients who are unable to pay. The federal health law assumed these funding reductions would be countered by states expanding their Medicaid programs. An expansion is optional for states, and Missouri doesn’t appear headed in that direction.

In the short-term, Liberty’s reduction in expenditures will translate to 129 jobs cut, the closure of its wound care clinic and its patient transportation program.

“The decision for the wound care was we simply did not have the patient load there to fully sustain it,” says Simpson. “For transportation, it’s a wonderful program. We wish we could continue it, but it’s one we could not find a financial option for.”

Simpson says these are tough decisions, but also admits some of the underlying changes the hospital is being forced to make may lead to improved care in the long run.

“We think the way we’re shifting our care at this point, focusing more on the core team members…and shifting away from part time employees into more full time employees and having stronger core nursing groups working together, from that perspective we really feel that our patient quality and our customer service will increase. We see that as a real benefit.”

Simpson adds that Liberty Hospital has no intention to merge or close. It wants to remain independent, though it is considering possible partnerships for providing some services.

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This story is part of a reporting partnership that includes KCUR, NPR and Kaiser Health News.